If you have inverted, or inward-turned, nipples, you may feel self-conscious about them. If your nipples are incapable of everting, turning outward, it may lead to awkwardness during intimate moments when your partner may not understand why your nipples do not turn outward. It is important to understand that inverted nipples are primarily a cosmetic problem. Other than potentially being harder to clean, inverted nipples usually function as well as everted nipples. But if your inverted nipples frequently make you self-conscious, it is possible to reshape them to create a more normal appearance.

DEGREES OF INVERTED NIPPLES

Inverted nipples are classified into three grades:

• Grade 1inverted nipples are typically inverted but will evert easily in response to touch or cold, and will remain everted with mild stimulation. Sometimes they are called “shy nipples.”
• Grade 2 inverted nipples are harder to evert and will tend to turn inward quickly, often despite continued stimulation.
• Grade 3 inverted nipples cannot be everted. These can cause hygiene problems because they are hard to clean and may tend to become infected.

All three grades of inverted nipples can be corrected through surgery.

No matter the degree of inverted nipple, most often women are still able to breastfeed. A baby will latch onto the breast, creating a good seal and then suction will stimulate the secretion of milk. Sometimes milk ducts are blocked, but this is a distinct problem from inverted nipples, though they may share a common cause.

CAUSES OF INVERTED NIPPLES

Most inverted nipples are congenital, just a normal variation on the nipple, and are genetic. Sometimes, though, inverted nipples can be caused by some medical conditions such as:

• Milk duct infection
• Injury to the breast
• Breast diseases such as mastitis, abscesses, or breast cancer
• Changes to the breast caused by pregnancy or breastfeeding

Women with congenital inverted nipples, especially shy nipples, often learn to cope with them, but acquired inverted nipples, especially when accompanied by other perceived negative changes in the appearance of a woman’s breasts, are more likely to make you feel self-conscious.

CORRECTION OF INVERTED NIPPLES

Inverted and everted nipples are the same shape, just reversed, so correction generally does not involve much alteration of the nipple itself. Most often, the problem is behind the nipple, such as scar tissue or the smooth muscle behind the nipple. Unless the problem is the milk ducts themselves, it is generally possible to maintain the function of the nipple so women who were previously able to breastfeed should still be capable following surgery. However, it is possible that a woman may lose sensation or the function of the milk glands after surgery.

Correction of inverted nipple can often be combined with other breast surgery, such as a breast lift or breast augmentation (especially when utilizing the periareolar incision).